Sleep research led to a new sleep apnea drug

People should be more aware of the symptoms of sleep apneas - the lack of energy during the day, feeling tired, waking up throughout the night, waking up tired/exhausted, etc. People with untreated sleep apnea have multiple folds higher chances to be depressed, unemployed, and have trouble with basic life functions, in addition to the long term health consequences of depriving your brain from Oxygen.

I've suggested 4 people over the last couple of years to get tested based on them casually mentioning some of these symptoms, and all 4 got diagnosed with moderate to severe sleep apnea (which is classified by the number of times you stopped breathing every hour - AHI, and the blood oxygen level). Getting tested is easy and cheap - you can find kits for under $100 which essentially are just a monitor you attach your finger + a few ECG stickers on your body which you use for a couple of nights. You can order them online without talking to a doctor, and you will get a prescription for CPAP if you are diagnosed as positive.

Treatment with CPAP is highly effective in eliminating these symptoms, and also reversing the brain damage (although MRI scans shows that it takes around a year for the gray matter in your brain to restore itself).

The other suggestion I'd make is that if you are overweight or obese, GLP-1 has proven to be also a miracle drug for sleep apnea. Unlike the study mentioned above, that essentially reduced the average AHI of participants by 4, which for almost everyone wouldn't cure them. Drugs like Zepbound have shown that over half are cured from sleep apnea after roughly a year of use. This is in addition to the other health benefits they provide with the weight reduction. Essentially. This unfortunately won't work for everyone, as weight is not the only cause of sleep apnea, but it is by far the most common one.

I don't have sleep apnea, as in, my severe snoring doesn't cause significant drops in blood oxygen levels, but it's still severely impacted my life - when my wife and I married, I spent the first night of our honeymoon awake so that she could sleep.

Oh and it's so loud that I'm at risk of damaging my own hearing.

And I bounced off CPAP hard, no matter what I tried, I would eventually remove the mask in my sleep, it was heartbreaking, I was so excited to finally be able to fall asleep beside my wife.

I also tried the mouth guards and would wake up panicking and gagging.

So my only other option currently is self-funding expensive surgery (our public system doesn't fund treatment for severe snoring unless it causes apnoea, and my private health insurance excludes the most expensive portions shrug), which like all surgery, carries no guarantees of success, and also carries the risk that any general anaesthesia application does.

So this is awesome! I just hope it continues proving efficacious and safe.

It's aroxybutynin 2.5 mg/atomoxetine 75 mg. They don't actually say in the article but the development code "AD109" leads to that

It only reduces by 4 events per hour. That seems like it might be helpful for someone with mild sleep apnea. But not with moderate or severe sleep apnea.

Adult AHI Severity Levels

Normal: Less than (5) events per hour.

Mild Sleep Apnea: (5) to (14.9) events per hour (frequent minor interruptions).

Moderate Sleep Apnea: (15) to (29.9) events per hour.Severe Sleep Apnea: (30) or more events per hour.

"By mapping the neural circuits that lead to this common condition, work from the Horner lab laid the foundation for AD109, a new treatment developed by researchers in Boston to specifically target the two pathways that contribute to sleep apnea. The daily oral medication contains two drugs: one that increases noradrenaline levels and another that blocks muscarinic receptors.

In a recently published phase 3 randomized clinical trial, people with mild to severe sleep apnea who received AD109 had less airway obstruction and higher oxygen levels than those who received a placebo. On average, per hour of sleep, participants on AD109 had four fewer events where they stopped breathing or had very shallow breathing."

The difference maker for me was an app, Snore Lab. that my son told me to try. It said that my snoring was EPIC. That led to my current CPAP use, for which the benefits [no daytime sleepiness, more energy, no food cravings] exceed the hassle [mask wearing, cleaning routine, supplies reordering.]

Four events per hour AHI improvement would not be a meaningful change for my therapy, but this is the beginning of better treatment options in the future.

The best benefit of CPAP is that it thwarts heart arrhythmias which arise from depriving the brain of oxygen.

I wake up without my cpap mask after a few hours every night. In total I might get 6 hours with it after putting it on multiple times.

Doctors think I’m doing fine due to total amount of hours used, and my resmed cpap claims I’m at below 1 event/hour. I’m not doing fine and I think the numbers are lying to me.

I snore a million, my mouth gets dry, and my nose tightens up, so my nasal mask isn’t always that nice to use. Other masks also annoy me.

What do? I haven’t sleep a solid 8 hours for 3-4 years :(

I highly recommend BongoRX (https://bongorx.com/) if you have sleep apnea and can't deal with CPAP. The mechanism: it makes it a little harder to breathe out, which keeps your airways more open when you breathe in next.

The pictures on the website are a little misleading: it comes with a strap to keep the device in your nostrils, so they don't just fall out in the middle of the night.

FDA-approved, and does require a prescription...

The drug is called AD109, but the title seems misleading as the drug is apparently still under trial, though it has shown good results there so far

Great. Something like 60% of OSA cases are linked to obesity. GLP-1 drugs could probably lead to resolution for a lot of them if the Lilly SURMOUNT-OSA trial tells us anything.

Surprisingly the most effective treatment I've found for my own apnea is just wearing an inexpensive soft cervical collar to sleep, but there are lots of different things that can contribute to sleep apnea, so YMMV.

After dealing with unexplained ectopic heartbeats (sometimes PVCs, sometimes PACs) I saw a chain of doctors and that included both getting a sleep study done and seeing a cardiologist.

I was diagnosed with mild apnea (AHI just above 10), but despite the apnea being mild on the AHI scale, my Sp02 blood oxygen percentage was dropping into the low 80%s for extended periods per night down from a normal 95-99% most of the time.

I weigh 180 lbs at 6 foot 2, being overweight was a non-factor in my apnea.

Got a CPAP machine, it helped but even after dialing in my personally optimal pressure settings using the CPAP data with OSCAR my AHI was still kind of all over the place, from under 1 to as much as 6 seemingly randomly per night with no mechanical issues like mask leaks showing up.

Had heard (on reddit /r/CPAP) about some people using soft cervical collars to help with their apnea and I gave it a try and when wearing one my AHI drops down to 0.0 - 0.4 per night. The collar alone helps more consistently in my case than the CPAP machine does.

Basically my sleep apnea is almost entirely due to the fact that when I'm sleeping (even on my side, but worse on my back) I seem to naturally tuck my chin in toward my neck in a way that constricts my upper airway and the collar stops this from happening. This is very much YMMV, there are lots of different causes of apnea.